F.J. Rietveldhttp://repub.eur.nl/ppl/4165/
List of Publicationsenhttp://repub.eur.nl/eur_signature.pnghttp://repub.eur.nl/
RePub, Erasmus University RepositoryA new surgical technique for deep stromal, anterior lamellar keratoplastyhttp://repub.eur.nl/pub/9117/
Fri, 01 Jan 1999 00:00:01 GMT<div>G.R.J. Melles</div><div>F. Lander</div><div>F.J. Rietveld</div><div>L. Remeijer</div><div>W.H. Beekhuis</div><div>P.S. Binder</div>
AIMS: To describe a new surgical technique for deep stromal anterior
lamellar keratoplasty. METHODS: In eye bank eyes and sighted human eyes,
aqueous was exchanged by air, to visualise the posterior corneal
surface--that is, the "air to endothelium" interface. Through a 5.0 mm
scleral incision, a deep stromal pocket was created across the cornea,
using the air to endothelium interface as a reference plane for dissection
depth. The pocket was filled with viscoelastic, and an anterior corneal
lamella was excised. A full thickness donor button was sutured into the
recipient bed after stripping its Descemet's membrane. RESULTS: In 25
consecutive human eye bank eyes, a 12% microperforation rate was found.
Corneal dissection depth averaged 95.4% (SD 2.7%). Six patient eyes had
uneventful surgeries; in a seventh eye, perforation of the lamellar bed
occurred. All transplants cleared. Central pachymetry ranged from 0.62 to
0.73 mm. CONCLUSION: With this technique a deep stromal anterior lamellar
keratoplasty can be performed with the donor to recipient interface just
anterior to the posterior corneal surface. The technique has the advantage
that the dissection can be completed in the event of inadvertent
microperforation, or that the procedure can be aborted to perform a
planned penetrating keratoplasty.